Intra-operative imprint cytology for assessing the sentinel node in breast cancer – Results of its routine use over 8 years

Contractor, Kaiyumars; Gohel, M.S.; Al-Salami, E.; Kaur, Kamaljit; Aqel, Nayef; Nigar, E.; Burke, Michael; Singhal, Hemant

doi:10.1016/j.ejso.2008.04.005

Cited by 19 publications

(15 citation statements)

References 32 publications

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“…False-positive results that could lead to unnecessary ALND are very rare. The sensitivity of 90% of our research compares favorably with other reported studies of IC and FS 12,22,23. Therefore, IC is definitely an easy, quick, sensitive, and accurate method for the intraoperative assessment of SLN in BC patients.…”

Section: Discussionsupporting

confidence: 77%

Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer

Petropoulou¹,

Kapoula²,

Mastoraki³

et al. 2017

BCTT

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IntroductionSentinel lymph node (SLN) biopsy is the gold standard for surgical staging of the axilla in breast cancer (BC). Frozen section (FS) remains the most popular means of intraoperative SLN diagnosis. Imprint cytology (IC) has also been suggested as a less expensive and equally accurate alternative to FS. The aim of our study was to perform a direct comparison between IC and FS on the same SLNs of BC cases operated in a single center by the same surgical team.Materials and methodsInto this prospective study we enrolled 60 consecutive patients with histologically proven T1–T3 BC and clinically negative axilla. Sentinel nodes were detected using a standard protocol. The SLN(s) was always assessed by IC as well as FS analysis and immunohistochemistry. Nevertheless, all intraoperative decisions were based on FS analysis.ResultsDuring the study period 60 patients with invasive BC were registered, with 80 SLNs harvested. Mean number of SLN(s) identified for each patient was 1.33. The sensitivity and specificity were 90% and 100%, respectively, for IC, and 80% and 100% for FS. Relevant positive/negative predictive values were 100%/98% for IC and 100%/96.15%, respectively, for FS. Overall accuracy was 98% for IC and 97% for FS. Therefore, statistically significant difference between the two methods in the detection of positive nodes was not elucidated (p=1.000).ConclusionsIC appeared to be marginally more sensitive than FS in detecting SLN metastatic activity. Overall accuracy was 98.75%. With regard to the primary lesion characteristics, we conclude that initial lesion size and lymphovascular invasion play a pivotal role in metastatic involvement of the SLN with the dimensions of metastasis bearing no correlation with tumor size. Therefore, IC appears to be a sensitive and accurate method for the intraoperative assessment of SLN in BC patients, but further studies are required to confirm this interesting data.

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Section: Discussionsupporting

confidence: 77%

Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer

Petropoulou¹,

Kapoula²,

Mastoraki³

et al. 2017

BCTT

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“…As SLNB has become an accepted method for staging the axilla, the role of axillary dissection is usually in the surgical treatment of established node‐positive disease. False‐negative tests arising from intraoperative assessment of the sentinel node occur, and a second surgical procedure to the axilla after definitive histology is recommended in up to 5 per cent of women19–23. In centres where intraoperative assessment of SLNB is not possible, a positive result often leads to the recommendation for a second axillary procedure.…”

Section: Discussionmentioning

confidence: 99%

In vivostudy of the surgical anatomy of the axilla

Khan

Chakravorty

Gui

2012

British Journal of Surgery

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“…11,48 Touch imprint cytology involves dissection of a resected lymph node and then pressing the cut surface onto a glass slide. 45,49 Scrape cytology involves scraping the cut surface of the lymph node onto a glass slide, 47 resulting in a cellular deposit that can be routinely fixed and stained. 50,51 In both techniques only a fraction of lymph node tissue is examined, which may not be representative of the entire node.…”

Section: Rapid Section Preparation Methodsmentioning

confidence: 99%

“…Other methods of rapid lymph node assessment have been developed including touch imprint cytology, scrape cytology and frozen section analysis . Touch imprint cytology involves dissection of a resected lymph node and then pressing the cut surface onto a glass slide . Scrape cytology involves scraping the cut surface of the lymph node onto a glass slide, resulting in a cellular deposit that can be routinely fixed and stained .…”

Section: Intraoperative Approachesmentioning

confidence: 99%

“…Scrape cytology involves scraping the cut surface of the lymph node onto a glass slide, resulting in a cellular deposit that can be routinely fixed and stained . In both techniques only a fraction of lymph node tissue is examined, which may not be representative of the entire node . These methods are also not likely to detect micrometastasis and ITC .…”

Section: Intraoperative Approachesmentioning

confidence: 99%

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Beyond conventional pathology: Towards preoperative and intraoperative lymph node staging

Winter

Gibson

Ruszkiewicz

et al. 2014

Intl Journal of Cancer

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Accurate detection of lymph node metastases is critical for many solid tumours to guide treatment strategies and determine prognostic outcomes. The gold standard for detection of metastasis is by histological analysis of formalin-fixed paraffinembedded (FFPE) sections of removed lymph nodes; this analysis method has remained largely unchanged for decades. Recent studies have highlighted limitations in the sensitivity of this approach, at least in its current clinical use, to detect very small metastatic deposits. Importantly, the poor prognostic outcomes associated with the presence of such small tumour deposits are now well established in a number of cancers. In addition, histological analysis of FFPE sections cannot be used practically for intraoperative node assessment. Novel lymph node staging technologies are therefore actively being developed. This review critically presents the main advances in this field and discusses why these technologies have not been able to provide a better alternative to the current gold standard diagnostic technique.Localized spread of cancer cells to lymph nodes has been established as one of the most significant prognostic indicators, and consequently its identification is of the highest importance in clinical oncology and a key element of solid tumour staging. The gold standard for the detection of lymphatic involvement is the postoperative examination of formalin-fixed paraffin-embedded (FFPE) sections of the resected lymph nodes. However, recent studies have shown limitations of this technique's sensitivity to detect occult tumour deposits in lymph nodes.

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Intra-operative imprint cytology for assessing the sentinel node in breast cancer – Results of its routine use over 8 years

Cited by 19 publications

References 32 publications

Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer

Imprint cytology versus frozen section analysis for intraoperative assessment of sentinel lymph node in breast cancer

In vivostudy of the surgical anatomy of the axilla

Beyond conventional pathology: Towards preoperative and intraoperative lymph node staging

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